蚌埠地区30例糖耐量受损者10年后转归分析  

The Prognosis Analysis of 30 Cases with IGT after 10 Years Follow-up in Bengbu Area

作　　者：张晓梅[1] 徐浣白[1] 潘明麟[1] 石建华[1] 时照明[1] 陈凤玲[1] 周纯先[1] 孙卫华[1] 张士荣[1] 陈建文[1] 黄詠齐[1] 

机构地区：[1]蚌埠医学院第一附属医院内分泌科,安徽蚌埠233004

出　　处：《中国慢性病预防与控制》2009年第2期167-169,共3页Chinese Journal of Prevention and Control of Chronic Diseases

基　　金：安徽省卫生厅基金资助项目(2002A040)

摘　　要：目的分析糖耐量受损(IGT)者10a后转归情况。方法1995年普查出的30例IGT者予以生活方式及药物干预,10a后对该人群进行问卷调查、体格检查和实验室检测。结果30例IGT患者中7例(23.3%)发展成糖尿病,13例(43.3%)仍为IGT,10例(33.3%)逆转为正常糖耐量(NGT)。IGT患者初查时TG、胰岛β细胞功能指数(HBCI)糖尿病转归组高于IGT转归组、NGT转归组,差别均有统计学意义(P<0.05或P<0.01);尿白蛋白排泄率(UAER)糖尿病转归组>IGT转归组>NGT转归组,差别均有统计学意义(P<0.05或P<0.01);糖尿病转归组体质指数(BMI)、腰围(WC)、2h血糖(2hPG)、收缩压(SBP)、HOMA-IR均高于NGT转归组(P<0.05);糖尿病转归组、IGT转归组舒张压(DBP)均高于NGT转归组(P<0.05);空腹血糖(FPG)、胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)在各组间差别无统计学意义(P>0.05)。10a后,糖尿病转归组肥胖、腹型肥胖患病率均85.7%高于NGT转归组(均为20.0%),差别有统计学意义(P<0.05);视网膜病变、肾病、神经病变检出率(71.4%,71.4%,57.1%)糖尿病转归组高于IGT转归组、NGT转归组;糖尿病转归组、IGT转归组心脑血管病检出率(85.7%,61.5%)高于NGT转归组(10.0%)。结论IGT、糖尿病转归者均合并代谢异常疾病,且IGT阶段即可有糖尿病慢性并发症发生,应尽早发现、综合干预其以逆转IGT加强控制代谢综合征相关临床指标。Objective To analyze the prognosis of people with impaired glucose tolerance （IGT） after 10 years follow-up. Methods 30 patients with IGT, screened out in 1995 census, were intervened with medication and the change of life style for ten years. Results There were 7 cases （23.3%） in 30 patients with IGT were developed into DM and 13 cases （43.3%） were still IGT, others （10 cases, 33.3%） were reverted to NGT. In the beginning of the study, the means of TG and HBCI in DM turnover group were significantly higher than those of IGT and NGT turnover group （P〈0.05 or P〈0.01）; The mean of UAER in DM turnover group were significantly higher than that in IGT turnover group and NGT turnover group in sequence （P〈0.05 or P〈0.01）; The means of BMI, WC, 2 h PG, SBP, HOMA-IR in DM turnover group were significantly higher than those of NGT turnover groups （P〈0.05）. The mean of DBP in DM and IGT turnover group were significantly higher than that of NGT turnover group, there were no difference in the means of FBG, TC and HDL-C between groups （P〉 0.05）. After Ten years of follow-up, the prevalence rates of obesity and abdominal obesity in DM groups were significantly higher than those in NGT group （P〈0.05）; the detection rates of retinopathy, nephropathy, neuropathy in DM groups （71.4%, 71.4%, 57.1%） were significantly higher than those in IGT （7.7%, 7.8%, 7.7.%） and NGT group （10.0%, 10.0%, 0%）; CVD detection rate in DM and IGT groups （85.7%, 61.5%） were significantly higher than that of NGT group （10.1%）. Conclusion The risk factors for IGT reverting to DM were BMI, WC, 2hPG, SBP, DBP, TG, UAER. We should find early and comprehensive interventions to revert IGT.

关 键 词：糖耐量受损 糖尿病 转归 

分 类 号：R589[医药卫生—内分泌]